Boosting HIV/AIDS fight

Health Minister Terrence Deyalsingh recently estimated that 11,500 people are living with HIV/AIDS in this country alone. While the figures are difficult to track, this is by any standard a high number. And it is likely to represent 75 per cent of the total picture. According to Deyalsingh, the aim is to get 90 per cent of all cases documented and treated by 2020.

In Trinidad and Tobago, like in many other countries around the world, the situation facing people with HIV/AIDS has changed dramatically.

There are highly effective treatments now available. Unfortunately, the progress has been such that some degree of complacency has crept in. For example, people having unprotected sex is not uncommon, according to many indicators.

Locally, organisations such as the Family Planning Association have done stellar work and have greatly enhanced their services to the public. But there needs to be more visibility when it comes to the State’s own policies in relation to the issue. Indeed, what is the current policy? Are we still guided by the Ministry of Health’s 2010 manual? If we are not cautious, this country could follow others where the challenges continue to rapidly shift.

For example, recent data from South Africa shows that young women are acquiring HIV from adult men, while men acquire HIV much later in life after they transition into adulthood and continue the cycle of new infections.

While globally the majority of new infections were among the general population, there are worrying trends in key populations.

In 2014, an estimated 45 per cent of all new HIV infections globally were among members of key populations and their sexual partners.

The latest report warns that new HIV infections are continuing to rise among people who inject drugs (by 36 per cent from 2010 to 2015) and among gay men and other men who have sex with men (by 12 per cent from 2010 to 2015) and are not declining among sex workers or transgender people.

It seems that inadequate outreach, lax policy or continuing stigmatisation has done little to keep these target populations within the reach of intervention.

At the same time, the latest UNAIDS report also shows that the life-extending impact of treatment is working. In 2015, there were more people over the age of 50 living with HIV than ever before — 5.8 million.

The report highlights that if treatment targets are reached, that number is expected to soar to 8.5 million by 2020. Older people living with HIV, however, have up to five times the risk of chronic disease and a comprehensive strategy is needed to respond to increasing long-term healthcare costs.

Trinidad and Tobago must work even harder when it comes to instances of mother-to-child transmission.

The state of play is such that there is no reason why these instances cannot be eliminated completely.

We are of the view there needs to be more open discourse on matters relating to sexuality. The failure to hold this discourse has done little to tackle the genuine public health issues that are posed by HIV/AIDS.

We need to talk about sex, we need to be able to advocate safe sex, we need to treat people who may be vulnerable, and we need to do so professionally and without prejudice.

The religious leaders must come on board more fully.

Still, our senior officials need to stop hiding behind fig leaves and scandals and encourage genuine openness on the matters that really affect us most. Let’s use December 1 as a moment to boost our fight.